- Refers to an intermittent or continuous expression of liquid from the anus.
Synonyms include: anal discharge, rectal mucus, anal drainage, anal seepage, and anal leakage.
A normal rectal mucus production is needed for proper excretion of fecal waste.
The term rectal discharge does not necessarily imply incontinence, but types of fecal incontinence that produce a liquid leakage could be thought of as a type of rectal discharge.
Different types of discharge:
Purulent rectal discharge
Mucous rectal discharge
Watery rectal discharge
Steatorrhoea
Keriorrhea-oily anal leakage
Rectal bleeding, melena and hematochezia
Feculent rectal discharge
Diarrhea
The most common presentation of a discharge is passage of mucus or pus surrounding an otherwise normal bowel movement.
Symptoms:
Staining of undergarments, feeling of dampness around anus, urge to open bowels, passage of only small amounts of mucus or pus-like liquid rather than normal feces, pain, rectal malodor, Pruritus ani, rectal bleeding, perianal erythema, swelling and tenderness
Pus usually indicates infection.
Normally mucus coats the walls of the colon. functioning as a protective barrier and also to aid peristalsis by lubrication of stool.
Mucous discharges occur as 3 broad categories:
Normal physiologically produced mucus
Inappropriately expressed physiologically produced mucus
Mucus produced in pathological quantities from a lesion, generalized coloproctitis or as a result of bacterial overgrowth.
Mucus may be associated with blood, and is referred to as “currant jelly” as seen in intussusception.
Currant jelly appearance refers to the mixture of sloughed mucosa, mucus, and blood.
Generally the etiology rectal discharge is due to infection and inflammation.
Some lesions can mechanically interfering with, or preventing the complete closure of the anal canal and cause discharge, by allowing transit of liquid stool components and mucus.
Common causes of rectal discharge are hemorrhoids, proctitis, anal fissure, rectal prolapse and perianal warts.
Less common causes include: colorectal carcinoma, irritable bowel syndrome, rectal ulcer syndrome, anal fistulae, villous adenoma, poor anal hygiene.
Rare causes include: sexually transmitted diseases, anal carcinoma, AIDS, rectal foreign body, bowel obstruction, rectocele, enterocele, ulcerative colitis, bacterial colitis, anal/perianal tuberculosis, perianal abscess, and intestinal parasitic infection.
The distal bowel continues to produce mucus despite fecal diversion after colostomy, often resulting in mucinous discharge.
Fistulae draining into the perianal region, pilonidal diseases and perianal tumors may cause rectal discharge.
When the fecal stream is diverted as part of a colostomy, diversion colitis may develop in the section of bowel that no longer is in contact with stool.
Short-chain fatty acids produced by bacterial fermentation, nourished the mucosal lining of the colon.
Long-term lack of exposure to these short-chain fatty acid nutrients can cause colitis.
Colitis symptoms include rectal bleeding, mucous discharge, tenesmus, and abdominal pain.
Anal carcinoma commonly causes bleeding, but may also cause anal pain, a lump, pruritus ani, discharge, tenesmus, change in bowel habits and fecal incontinence.